in terms of his principles. if you ask do i know what he stands for, and if he means what he says? well, he is looking a at these ideas but it is not the occasion that, for instance, the nobel peace prize when he talked about just war principles and why it was that we were present in iraq and afghanistan. i thought there he had come to the point where he now felt this is who he was and what he was standing for, but in general, he is a little bit of a cipher. you're not exactly clear where he's going to put his political capital and what he is willing to ak fies to -- to sacrifice for. that would be the challenge in an obama speech. host: quick question over here. >> i have a quick question. how do we help out mom an pop

businesses that are being killed by juggernaut corporations like walmart? guest: this is part of the argument of our day. i'm sure the folks in walmart would say, they're offering lower prices and they're more unionized and all that kind of thing, but if you travel around, there is no question, walmart takes business away from small business along main street. now, is this a benefit to the american people, to the american consumer? i guess so, because clearly people are taking their dollars to walmart. i don't think walmart is even in the midst of this recession, walmart has been doing pretty well, but if you're talking just in terms of american values, why is it that a mom and pop startup is struggling nowadays and shouldn't we care about that? well, i think we should care about that in terms of hiring, in terms of maintaining the kind of opportunity for entrepreneurs that is so essential to the american dream. a small business hires, also, so we want small businesses to

succeed in america. what can we do? i don't know at this point, if you're asking me how can they battle against a gargantuan enterprise that benefits from being so large, it is very difficult. what you're really talking about, then, is small business assistance, tax breaks for small business. you're looking at regulatory relief that would allow them to compete in ways that the big boys can't, and all of that is on the table. it's interesting, if you look at some of the small business policies that both president bush and president obama have pursued, they believe in small business. it's just that president bush's was much more about the tax cuts, president obama, much more on the other end of believing that if you give them health with healthcare reform and you help them with some of the kind of subsidies that would allow them to get started that then they can prosper, but in this economic environment, it really comes down to working with the banks, and making sure that the

banks are willing to open up the credit and support small business and especially the startups much more so than even small businesses that are already a going enterprise. host: juan williams is our guest. we conclude with a round of applause for the students here at the washington center. [applause] host: and also to our host here at the jack morton auditorium. thanks for being with us. guest: guest: my pleasure. this is a great audience. thank you. host: we are going to a news conference with mitch mccon al back from afghanistan and other republican leaders including lisa murkowski and mica sell of delaware, live here on c-span. we will be back at 7:00 a.m. east coast time.

[captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2010] .

the confusion surrounding detention policy. from the top to bottom, the military people that we talked to indicated some confusion operationally about what you do when you detain a terrorist. this confusion, in my view, one general, for example, did not want to answer the question without turning to his lawyer who was also in the room. this operational confusion has been created unnecessarily and frankly, dangerously, by the a demonstration. in fact, there are at least to standards of detention. if you are captured by an officer that is part of nato, there is one standard. if you are captured by a u.s.

soldier not under nato command, there is another standard. this sort of preoccupation, if you will, that we see on full display here in the u.s., with the example of the christmas would be bomber being turned over not to the military for interrogation, but to criminal courts and told to he is entitled to a lawyer is a mentality that i think is a very dangerous in the war on terror. we see this preoccupation with prisoners' rights, both on the foreign battlefields and here at home, it seems to be consuming the administration in this war on terror. i think it is wrongheaded. i have said it repeatedly. guantanamo should not be closed. there is a reason why we passed the military commission

legislation a few years ago. to not be allowed to properly interrogate and to detain without some of the concerns that you might have as an american citizen in the united states who was under arrest for robbing a convenience store or something strikes me as a pretty wrongheaded way to conduct a war. i am troubled by that and i hope that the administration will move in the direction of clearing up this confusion. i have found from top to bottom in iraq concern among military people about this state of confusion with regard to a detention and attainment. -- detainment. >> i share senator mcconnell concerns. it was very clear that there was uncertainty among our military personnel as to how they are required now and going

to be required in the future to deal with the handling of detainees. i wanted to make several points. first, it was very clear that the morale of our troops is very high. we have a tremendous fighting force in afghanistan and a very, very committed american soldiers who are doing their job. one of the impressive things i noted was where our troops have moved into a region. they have been successful in achieving their objective so far. their first objective was to clear the area of the taliban and to start the process of asserting a long-term control. it's very important point to make is that the morale is high. secondly, i was impressed with the quality of the american personnel there on the ground. not just our troops, but those who are running in managing all aspects of our actions in afghanistan and pakistan.

from the ambassador to the u.s. aid -- usaid personnel. i think americans can be confident and proud in the personnel we have on the ground to are doing such a good job. one other thing i want to comment on before i turn it over to lease that is that -- lisa is that there does seem to be a deficit of trust. both in terms of pakistani officials as well as afghanistan officials, they had a concern about whether the united states is going to finish the job. this is creating concern in both pakistan and afghanistan. in pakistan, as you know, a number of the senior taliban officials have moved across the borders from pakistan to

afghanistan. we need pakistan's assistance to clear them and to achieve the objective of stopping their operation. yet pakistan, i believe, is somewhat concerned about whether the united states is going to be withdrawing in 18 months and if so, whether it is a good move on their part to engage in trying to clear the taliban with whom they do not have a current conflict. on the afghanistan -- side of the border, there is a similar issue. as our troops clear an area, the process of holding and building the area back significantly involved winning the confidence and trust of the people in the region. if the people in the region think that the united states is not going to be there, and that the taliban will move in and fill that void, they have a much more difficult time making that decision to change their allegiance or move their loyalty

over and actively engage in the process of trying to help maintain the structure and the control that is established by our troops. for both reasons, there is a concern as to whether we are going to help move us forward and keep the job and concluded to the point where we can build up the afghan military police force and strengthen the situation. with that, i will -- lisa, your next. >> in our very short visit to afghanistan and pakistan, we had an opportunity to meet with the military leadership in both countries. the general is the head of the pakistani military as well as the prime minister of pakistan

and are meeting with president karzai. it was an interesting juxtaposition as we looked to the military component what is happening on the government's side in both pakistan and afghanistan. when it comes to the governance issue in afghanistan, in our meeting with president karzai, he stressed very much the significance of the upcoming parliamentary elections. the need to ensure that under the afghan constitution, that process moves forward to clearly define or establish the legitimacy of the afghan government and their processes as they move ahead. we also had an opportunity to visit the police training centers there in kabul. very important to understand the

progress that is being made at the afghan army is being trained. they truly are operating at a deficit in terms of the numbers and bringing more recruits in, but what they have seen in the past several months has been remarkable in terms of the numbers of recruits that have come in. we met with the minister of defense, who indicated that just in the past month, the number of recruits that they have received has been incredible. in fact, they have not been able to process them quickly enough as they come forward. i think we also need to understand that these recruits, as eager and energetic as they may be, have some issues. obviously, the biggest issue is the literacy rate. it is about 44% literacy rate

within afghanistan as far as the mint. the percentage of those who are literate that are actually going to train is even lower. where we were in the south, it is a different dynamic. this is where the center of the activity is right now. this is where we are seeing more of the taliban presence. unfortunately, we do not have as many police forces coming from the south as we do from the north. there is a lot of dynamics that are at play that make it more difficult. it was mentioned by senator about the morale of the american forces that are adair, the morale of the civilian forces -- that are there, the morale of the civilian forces. it is all very, very positive. very strong. but we also saw on the afghan side, as we talked to the tribal

leaders that we met with, the district governor, the governor, and the local tribal leaders there that -- there is very much a desire, a willingness to take this fight and have them be the ones that are in charge. when we walked through, we work with marines, yes, but those that were providing the protection for that the village were all local iraqi -- afghani police force. that was to was providing for the level of protection and security in a community that just two months before, and you are not able to walk freely through the streets. the combination of the american, the nato forces, in conjunction with a growing afghan army

presence is truly making a difference. slowly, but it is making a difference. >> thank you. i want to thank senator mcconnell for putting together a very good trip over a very short time. in pakistan and afghanistan, we had a chance to meet with the top military leadership. the leader of the army, not only the president of afghanistan, but the four officials that make up the defense of security establishment. we had a working -- we had a working dinner with the ambassador. these people, when asked, will tell you that the july 2011 withdrawal date is a problem. it is a problem that can be overcome, but it is a propaganda tool for the taliban, who are

spreading the message that the united states might not be there for the long haul. it is a propaganda tool for those people in the area who wish us well and would like to see us fail. our officials and the afghan officials are countering this by pointing out the statements made by the secretary of defense and by members of the administration. we are there for a long term strategic partnership. usaid is their big time. they are helping us after the clearing to begin the rebuilding phase and to show we are in a long term strategic partnership. we are building to consulates in remoter areas of afghanistan to show that we do not intend to leave and abandon afghanistan. it is a problem politically for

us with the 2011 date, but it can be overcome. by the same token, our generals understand the chain of command. the work for the secretary of defense and the president of the united states and they understand that. they're following his position with regard to capture enemy combatant spirit as the minority leader said, when asked the question, what do we do with captured enemy combatants, it was clear that the answer is confusion and uncertainty on the part of our troops and the afghan security forces. that is something that will have to be overcome. that said, we can overcome these two major concerns that senator

mcconnell outlined. i think there is a feeling among our troops, both at the top level, general mcchrystal and the troops we were able to visit with both in kabul and can leatherneck -- camp leatherneck, we are in a good position to win 2010. i think that will tell the tale, but i do think we have the right approach of clear, hold, and build, and sustain, and rely on local security forces. when the support of the local elders and tribal leaders. this is a strategy that can work and will work. there are problems that we have

caused here in washington d.c., but i think there are problems that can be overcome. >> i want to add one quick thing. for those of you who are students of history, it was said that even during the american revolution, our population was sort of in three groups. it is not uncommon, this feeling that we sense in afghanistan among the fence sitters to want to know how this is going to come out. i think convincing the fence sitters is a big part of stabilizing the country and putting it in the kind of condition where we can leave and drawdown with honor and leave behind a country that is dramatically better than it was when we went in. >> senator, would it help to

convince some of them if the united states would share droned technology with pakistan? do think that is a good idea? >> the whole policy -- the whole drone policy is something i would typically not discuss publicly. it is somewhat sensitive in that area of the world. i think it is a technique we have employed with somewhat success. >> what do think the emphasis should be during the london conference later on this month? >> i do not know, but it will be interesting to see what comes of the conference. there is widespread interest in participating and being helpful.

we're all pleased any effort that the pakistan military has made with considerable success and the efforts taken -- i think they fully believed it is a threat to the regime. it is a threat to the regime in pakistan. >> i want to briefly bring you back to the home front. some colleagues have called on harry reid to resign because of his controversial comments. do you agree? >> that is an issue for the democratic conference. >> do not agree then? >> i think it is an issue for the democratic conference. michael steele said on sunday that if you, mcconnell, had said similar words, then democrats would be calling for your head.

do you agree with that? >> who is going to be the democratic leader of the senate is up to the democratic conference. >> stanley mcchrystal said that he is turning the tide. when you talk to the afghan officials, did they look hopeful when it comes to the coordination and cooperation between afghanistan and pakistan, especially in the borderline along the tribal region and tribal area, because these two countries have had trust issues before? >> obviously, the afghans would prefer that the border area on the pakistan side be -- not be a safe haven for the afghan taliban which is headquartered over there. all of us emphasized to the pakistani leadership our view

that the taliban is a problem regardless, whether it is pakistan taliban or afghan taliban, and a greater level of cooperation between the pakistan government and the afghanistan government would be in everybody's best interest. the threats to both regimes are both -- are quite similar. >> the top intelligence official in afghanistan delivered a pretty scathing internal critique of the intelligence operations there. did you see or received any assurances that that has been turned around? >> say that again. >> he delivered a pretty scathing review of intelligence efforts in afghanistan recently. did you know about this critique and did you get any assurances that it is being turned around? >> i do not recall. anybody have an observation about that? i really do not have anything to

say about that. >> in your conversations with various officials about the pervasive corruption and how much that is interfering with efforts to turn anything around? >> it is a problem. it is a problem in a lot of places in the world, as you know. afghanistan is not unique in that regard. i think officials at the top understand that ultimately to have the kind of government that can enjoy the confidence of the people, this is going to have to be combated head on. i do not want to dominate the -- >> i would like to try this from another angle. if a republican had made comments to similar harry reid said, would you personally want them to surrender a leadership position? if that had been someone -- >> no matter how many different

ways to ask the question, who is going to be the leader of the democratic party of the senate is up to the democrats in the senate. >> what did you make of the comments? >> i really have said all i'm going to say on that subject. anybody else want to take it? >> i will respond in this way. i was on a statewide call in a radio this morning and there is a particular interest in our state because of what senator lott went through. the point i made and the answer was accepted, having come back from being with our troops, i'm a lot more concerned, frankly, that senator reid is the guy who a couple of years ago said the effort in iraq was lost.

i think the voters up nevada will make a judgment about that. i think they will make a judgment about the most blatant auction of of boats with this health care legislation in the history of the united states of america and i think the decision with regard to senator reid will be made by the voters of nevada. >> on the health-care issue, is this all but a done deal given last month or is there another opportunity to block final passage? >> we're going to do everything we can to stop this bill. it is interesting. it is noteworthy that in an election up in massachusetts, arguably the bluest state in america, the hottest issue is the health-care bill. i am told that the republican candidate in a debate yesterday, he emphasized that he would be the 41st vote to keep this

monstrosity from being hoisted onto the american people. the polls continue to receive in support of this proposal. i have great hope that enough democrats are going to wake up and say, we should not fum our noses at the american people and cram this down their throats, no matter what they think. it is an act of incredible arrogance. it is best summed up by saying, we know what ought to be done. you sit down and shut up, american people and let us do this for you. i think they get it. i think the majority gets it and they know how unpopular this is. i have some hope that they will have difficulty ramming this

massive restructuring of one sixth of our economy that cut medicare by half a trillion dollars in raises -- down the throats of the american people. >> another official in washington is michael steele it has caused some consternation among aides on capitol hill, i wonder, are you concerned about his "of late -- quotes of late? >> it be measured in two ways. how much money did you raise? how many elections did you win? that standard will be applied to this chairman as it has to others. >> you do not have any concern about -- >> chairman still will be bait -- judged on the basis of how much money did you raise?

how many elections did you win? >> what is your sense following your visit to afghanistan about economic development? what can be done to promote specific legislation? >> afghanistan used to be an agricultural exporter. we visited the area near the two rivers. when you think of afghanistan, and you think of these mountain ranges. down south, the areas along the rivers, it is very fertile. to the extent that they can get on top of the pop the problem and it agriculture growing again, afghanistan has a chance to feed itself and to even exports to its neighbors, which it did in the past. i do not know if anybody else would like to -- >> when we think about agriculture and how we are going to enhance economic opportunity,

you think about, let's grow some stuff. it is important to recognize that part of the dilemma that they face is held they then moved those legitimate agricultural products. when you do not have freedom of movement, as they currently do not, because of the corruption, because of the legal check points, which can encourage them all we want to plant the right things. if you cannot move it to market, it is a real problem. this is again where our security forces are in there on the ground making a difference. >> this is me and understand -- an opportunity to come back to the london conference. that is largely what the london conference, chaired by prime minister brown, is about. it is important to understand that the united nations will be there and is an integral part of

the overall effort in afghanistan. frankly, i think it helps us internationally. it helps us in world opinion and our troops appreciate the presence of the united nations. also, the united states, the united kingdom, but the scores of our allies are there in one form or another pushing in the same direction. they have different rules and there are different guidelines, but it is important to realize that there will be number of countries at the london conference hoping for success. one other thing i would add about the london conference is that there is a reconciliation and a reintegration process ongoing in afghanistan with former taliban moving back into society and moving back and

being part of the government and part of the afghan society. there is a real hope that japan had a particular interest in coming in with perhaps as much as several hundred million dollars to help with the reconciliation and reintegration effort and i hope that is part of the success story of the london conference. >> do you think that the united states and these national communities should be holding the karzai government as a benchmark ahead of the london conference? >> the london conference is right upon us. we are walking arm in arm with the karzai administration. we are coordinating with regard to election reform and i think we are of the same mind.

that should be a part of something in the near future. we're recording with the karzai administration as to when these parliamentary elections are held. i do know from talking with the president that he wants to follow the constitution and he wants to give the afghan people an opportunity to vote and to have an accurate vote count with regard to the parliament. >> when you said we are in a good position to win it 2010, i wonder about your thoughts -- >> this is a press conference about afghanistan and pakistan. it is a wonderful thing about our system. the american people have an opportunity to vote every two years. they have an opportunity to express their opinion about this stewardship of this administration and its majority. >> when you're talking about the deficit of trust, it sounded

like you had not convinced of pakistan people that you talked to that it was in their interest to not have the taliban people where they are. did you find when you were talking to the pakistani military that they still had some reluctance to go against the taliban? >> i think so. you have to understand that the word taliban is not just one thing in this region. for example, the pakistan government has taken strong action already against those elements of the taliban that are active in pakistan creating an existential threat to the pakistani government. they are taking action there. however, the afghan taliban, who have moved across the border into pakistan, have at this

point not posed a serious threat to pakistan. they are minding their manners in pakistan and using it as a sanctuary. the question is whether pakistan will a common view that part of the taliban community as a threat in pakistan or be, take the position that it should assist the afghanistan government and the americans and the coalition forces in afghanistan by helping to root them out. right now, one could say that in one context, the pakistan government is very much concerned about a portion of the taliban who are causing trouble in pakistan, but they are not yet convinced that they should take action across the board against all taliban, particularly those afghan pakistan -- teledyne who moved across for sanctuary.

was that your question? >> there working together. i did not know whether anyone in the u.s. called the pakistan is to focus on it -- >> i believe it is very clear that one of the u.s. goals to help pakistan to understand that the entirety of the taliban threat is real and to take action against the afghan taliban in pakistan. however, i also believe that -- there is some progress there. they are a threat to pakistan. i do not believe that the pakistan government has yet moved to that point. frankly, i think it is a source of some conjecture or speculation among many people as to whether they will and if so,

when they will, and to what extent they will begin taking action against the afghan taliban. >> could i just add one point? i agree with everything might said. to the extent that's -- everything mike said. to the extent that we will be there. the attractiveness of ignoring the afghan taliban in pakistan goes down. >> the general you sat down with had a lawyer with him, i wonder if you could tell us to the general was. is that unusual when you travel to the region? >> i am not going to tell you who. i will tell you from all the way up and down the chain, we asked the question about the detainee issue. i think it is any -- not in any

way in overstatement to say that the situation is confusing to our leadership and our troops in the field. it needs to be cleared up. with regard to the question about whether i have in the past had military leader referred to his lawyer, i have not in the past. i have been on a number of trips over the years. i find that unusual. thank you, everyone.

>> senators just back from afghanistan and pakistan. the u.s. senate will be back for another week to january 25. the u.s. house is getting ready to start the second session of the 111th congress able be in for a brief session at noon today before taking bold call at 6:30 -- taking roll call at 6:30 p.m.. live coverage of the house on c- span. the senate will be back next wednesday, the 28th, it 10:00. senate coverage is on c-span2. our coverage of state of the state addresses continues this afternoon in new jersey. you can follow that here on c- span at 2:30 eastern. later, a briefing on the reallocation of the broadcast spectrum for emergency personnel. that is at 5:00 eastern. did you know that the number one

free news app for your iphone or your ipod touch is c-span radio? you can get quick and easy access to three streaming audio channels. c-span radio + c-span2 + c- span2. it is all free and available from the app store. >> the pentagon and veterans affairs department held a joint conference on monday on military suicide prevention. speakers include eric stanchion secchi -- ericsson shacky. this is one hour and 15 minutes. we have been putting together

quite the agenda for you. we have over 100 presenters this week. we're really excited. some of the most well-known experts in the field of suicide, so we have quite the agenda. i am the chair of the suicide prevention and risk reduction committee. i am a public health service officer. but i would like to do is take a few minutes to go over some administrative announcement. during all breakout sessions, please silence yourself phones and please do not turn them to vibrate as this can also be distracting and interfere with the audiovisual in the room. we have allowed for 15 minutes between sessions, so please be mindful of the time and ordered to get to your next session promptly, so that we can stay on schedule. we're a little behind the curve, so we want to make sure that we stand target. there are restrooms located on

each floor of the hotel. if you have not done so already, please sign up at the registration desk. each breakout session, you will be evaluated individually, so please place your completed evaluation in the collection boxes located outside of each room and at the registration desk. he has requires 09% attendance -- 100% attendance policy. for additional information, please review the blue sheet paper in your folder. i would like to introduce you to my cochair. [applause] >> we sincerely hope that the

conference will meet your expectations and provide all of us with ideas and lessons we can all learn to take back, and for the future. if you have any concerns or questions or ideas, please feel free to find either one of us. we would also like to have you take a look at your agenda. as we go through this process, you are able to use that quiet room every day if you find that the topics are a little difficult for you. we wanted to make sure you were able to go somewhere for a short break if you need to do that. i would like to introduce you to our director -- general sutton has been leading for the last two years and is very passionate about the issue of suicide prevention. [applause]

>> thank you so much. i would like to welcome everyone of you here today. this is the second annual dod va conference on suicide prevention. we have a number of distinguished guests who will be joining us today. some of them are already here. i would like to give a special welcome to elena -- ellen embry. we're honored to have eric shinseki. we also have lieutenant general who is the deputy director of

manpower. we're also pleased to welcome major general who is the deputy commander for the joint task force capital medicine. we also have dave smith who is the joint staff sgt. we also have the deputy surgeon general for the united states air force. we also have bonnie carroll, many of us know her as the director of the treasury assistance program for survivors. please join me in welcoming our distinguished guests. [applause] i cannot tell you what it is to look across this audience to

note that of all of the things that are demanding our attention, that each of you would make this a priority. clearly, it speaks volumes. this is not business as usual. we are here over the next few days to learn, to share, to grow, to connect. as i look across this room, i see colleagues and friends. i see folks from across the services, army, navy, air force, marine corps, a coastguard, public health service. i see the backbone of our military. i see retirees, widows, family members who have survived the tragedy of suicide and two are truly our best experts from whom we must learn and for whom we

must continue to support. please join me in thanking the suicide family survivors who are here to teach us this week. [applause] you know, a wise person once said, the kinder than it necessary -- be kinder than necessary for everyone we meet is fighting some sort of battle. i know i am. i know you are. those battles are not limited to the war zone. they take place on the home front. they involved struggles with injuries that our moral, physical, psychological, spiritual, seen and unseen.

they also lead to the potential for us to claim strengths, no matter how adverse our experience has been. over the next few days, we have the opportunity to learn new and better ways of strengthening individuals and communities, to build resilience, and to maximize recovery, and to foster reintegration at all levels. preventing suicide involves much more than recognizing and acting on of the terminal signs of hopelessness and despair. as a port -- as important as those actions are, it involves for each one of loss to build,

develop, to grow the tool kit for life. one that involves tools for sleep. the number-one issue effecting our troops coming back and forth from the battle zone. it involves the tool of fuel. are we putting the kind of fuel into our body that help our brains, our bodies, our souls, our spirits perform at maximum effectiveness and efficiency? got friends? to each of us here today have at least two people that, if we were to reach that hour of darkness, that moment of truth, that we could call a friend?

and gain that human to human, heart to heart connection. do we belong to 18? -- to 18? -- to a team? those relationships are what life is all about. that glove? -- got love? do we have people in our lives, pets, causes, and debtors -- endeavors, that we put their needs ahead of our own? do we have health? the presence of energy, optimism, compassion, grace,

gratitude, grit, and strength? do we have faith? faith that leads us to a commitment that is greater than a any of us as individuals? hope? any of us who is without hope most at risk. growth, that potential for claiming post-traumatic growth no matter how tough the adversity. it is there for each of us. granted there are other domains, resilience, but i would have this to say. if every one of our front line of leaders, those young troops in the trenches, if they knew the answer to each of those questions about their troops, if

we knew the answers about our family members, our leaders, ourselves, and knew how to engage each other in a meaningful productive dialogue, perhaps we would be a step further away from the terminal signs of hopelessness and despair. that is our challenge. this is not business as usual. for as much as we have learned, for as much as the already know, we know, for example, that preventing suicide is first and foremost a public health challenge. think of it this way. at the center of our attention, eyes on the prize, the health and well-being of our warriors, our veterans and yes, our families, those who are courageous enough to love us, but it goes on from there. we must build peer to peer support networks. we must build resilient families

and communities, faith leaders, employers, teachers, coaches, elected officials. yes, health care professionals. but let me be clear. preventing suicide is far too important to into enormous of a challenge to be left to the doctors. we are all in this together. we are our brother's keeper. we are our sister's keeper. we know that psychological, spiritual, and moral injuries, are on par with physical injuries. the chairman of the joint chiefs of staff's says that frequently. we are blessed with the strength of a visionary leadership at all levels and in both departments. we know that these in visible wounds of war, whether

depression, posttraumatic stress, anxiety, concussion, traumatic brain injury, we know that these in the duke -- invisible ones are real. -- wounds are real. we are all in this together. we know that treatment works. treatment based on an integrated team help model of care that covers the entire continuum, from the point of entry or distress all the way through. from the battlefield to the home front to the bedside to the kitchen table. we also know that not only does treatment work, but the earlier we can intervene, the better. we know that reaching out is an act of courage and strength. as hemingway once put it,

following world wari, the world breaks everyone and many grow stronger at the broken places. finally, we must double down on our commitment to eliminate, not just to minimize, not just to reduce, but to eliminate stick on that toxic deadly hazard that all too often lead to needless suffering and loss. in summary, we are on a journey. we know that stigma can killed. words can work. help is hope. we're on a journey where

perhaps someone in the wisdom of churchill, we are at that point, we're not at the beginning. this is not the end of the beginning. this is not the beginning. this is not the beginning of the end. this is perhaps the end of the beginning. a time where we can look back and learn and we kennett tool up here today, this week, go home and apply these lessons. ask ourselves the question every day, it is what i and what my team are doing today, is this action? is our efforts worthy of the service and sacrifice of those who worked so privileged to serve? not content with today's best, we must make today's best better every single tomorrow and

the day after and the day after. to this end, i am deeply honored to introduce our first guest speaker for this morning. a fellow traveler on this journey, a 34 year veteran of the department of defense, someone who has pioneered our understanding and our efforts in support of health protection and readiness. someone who more recently i have had the opportunity, the privilege of serving with these last couple of years in the domain of the in visible -- of the invisible ones of war, psychological help, traumatic brain injury. performing the duties of the assistant secretary of defense, ellen embry comes to us today as

much more than a distinguished leader and esteemed colleague, although she is both of those things. to some many of us, we did to so many of us, she is a role model. she is a mentor, teacher, coach and a dear friend. please join me in welcoming her. [applause] >> good morning, everyone. i am here on behalf of the secretary of defense. mr. gates was not available today and so he asked me to come in and provide some opening remarks on behalf of the

department. i am very pleased to do so. thank you, general sudden, for those very kind words and that wonderful introduction. good morning to everyone. welcome to this second annual conference on suicide prevention. it is the only conference established to specifically address the issue of suicide in the military and a veteran population. it is very important that you all are here. it is quite obvious that you care and you spend many of your days and nights caring about this issue and making a difference and the lives of our service members and veterans and their families. i want to thank the distinguished guests who are here who were mentioned earlier and of course, i would like to thank the chairman of the joint chiefs of staff admiral mullen who will be here later. . .

and helping us all to see and address as a matter of priority the unseen once a war. i would also like to thank our conference call hosted a partner, secretary shinseki. so, let's talk a little bit about the tragedy of suicide. every life lost to suicide is both a personal tragedy and a tragedy to society. whether civilian or military, it is a tragedy because of a human life has been lost. it is also a tragedy because for all of our sophisticated knowledge, we still do not know all there is to know about preventing these needless deaths from occurring. at a media roundtable last

november, the army's vice chief of staff briefed the press on his service's suicide prevention efforts. the challenge of suicides, he said, is without a doubt the toughest i have had to tackle in 35 -- 37 + years in the army. simply stated, he said it is not a single problem with the defined set of symptoms or markers. there are no easy answers or solutions. and as we all know, he is right on all counts. suicide is a complex issue with any number of risk factors. it is hard to predict. while we are alarmed at the number of suicides increasing in the military, some 311 occurred in 2009, most not occur in the theater of operations. most are related to the same factors that precipitate

civilian suicide. substance abuse, failed marriages, or relationships, and a legal or financial matters. according to a 2008 department of defense report, 64% of those who died by suicide did not have a diagnosis psychiatric disorder. 49% received medical, of haverhill, and family services 30 days prior to their deaths. knowing this, what is it that we can do to reduce the risk and the number of suicides in the armed forces? -we should make sure that people understand there is a wide variety of resources to help them before they become suicidal. that means increased sensitivity to warning signs, comprehensive prevention and education

prevention and education services t their career and programs that target risk factors. increased access to information and care, enhance community and peer support, and finally, and most importantly, quality research, surveillance, and analysis to close our gaps in understanding and to identify best practices for prevention. sigma is another key to prevention. we have taken steps to reduce the impact of seeking help. the real warriors, real battles, real strength campaign provides examples of members who have saw care for psychological health issues and yet still

maintained a highly successful military careers. there are several web sites in self assessment programs that help to enable our service members and families is to seek help confidentially and identify problems before they become serious. video and other educational materials are in widespread use helping families and children to cope with deployments. telephone hot lines, with licensed mental health consultants provide help. there are multiple transition programs available to help bridge the support of our service members who are between health care providers or systems, according not just support and encouragement, but also continued use of needed services. in short, that as far as the department of defence is concerned, there is no

individual, family member, military leader, or va or dod or other community resource that could be omitted from the suicide prevention equation. because suicide is a great concern for the department of defense, each of the individual military services have instituted significant efforts and programs to prevent suicide. for example, the air force has inc. suicide prevention into -- incorporated suicide prevention into their programs. they have trained over 1000 mental health staff at 45 installations. . .

they have also a 00 bus and integrated analysis and to identify trends and risk factors that enables their leaders and others to intervene at multiple levels to reduce suicides. the marines have implemented a program involving a two-hour suicide prevention training session for 100% of the marines. that session include warning signs, engagement with fellow marines, in an information with how to access a variety of local and national resources. removes -- help reduce state month, and a

suicide prevention message is incorporated into the marine mandatory martial arts training program to demonstrate the value of resilience and the importance of seeking ways to identify and mitigate emotional stress. in addition, the marines had implemented a dedicated hotline to a nss those with relationship rock -- to aid and assist those with relationship problems. the navy has a group to highlight education including a comprehensive program to address psychological help needs of sailors and their families. they have conducted a personal readiness summit with reconcentration areas on a range of topics including suicide prevention and operational stress. in addition to a trained program -- a trainer program that was

established at locations around the code, they have also assisted leaders in recognizing and responding to sailors in distress. many of these examples are not inclusive, but they highlight a holistic and comprehensive strategy that we attempt to bring to bear to confront the challenge of suicide. we're doing is primarily for increasing information and awareness, bringing very -- bringing very strong levels of support at a 360 degree level and reducing statement to the extent possible to those who are trying and need to get help -- and reducing stigma to the extent possible to those who are trying and need to get help. this is not just our commitment, but our obligation to men and women who sacrificed so much to keep our country strong and free and able to do what we do

on a daily basis. we owe them a debt of gratitude. we owe them the very best that we can give them. we are committed to reducing the burden of suicide. the communities of partnership of both the department of defense and the department of veterans affairs are absolutely dedicated to this issue. our attention will not flag and our dedication will not falter. part of that dedication and commitment is conferences like this one. it is designed specifically to actively engage service members and their families in suicide prevention. and to provide the resources that we need and ultimately to improve those resources and the substance that drives their success. we want to reduce the number of suicides among our veterans and in the military, and hopefully what we learned will transcend

it to the national risk suicide prevention as well. i want to thank you all for coming. i know that this conference is important and i hope that when this is over, you will be able to take away significant things that you can do back in your job to improve what we do for our soldiers, sailors, airmen, marines, and coastguardsman. thank you. [applause] >> ladies and gentleman, please welcome back to the stage commander talkinhawking. >> the senior vice president for a foundation attained the rank

of major in the years following his military career. on may 16, 2005, he was medically retired from the u.s. army from injuries sustained in combat. on the 17th of august, 2004, he hit an ied, otherwise known as a roadside bomb. this happened while he was serving with the coalition of military assistance training teams under the command of then- commander david petreaus. due to the extensive injuries to his left knees, doctors had to employment -- amputate his left leg. his story of courage and sacrifice has been featured in "time magazine," fox news, cnn, and many national and other television stations and newspapers. senses amputations, he has been a staunch advocate for veterans

with disabilities, specifically focusing on advocacy for prosthetic technologies you're visiting with fellow amputees at walter reed medical center -- prosthetic technologies, peer visiting with fellow amputees at walter reed medical center. he experienced much of what other 6 pairs. he entered darkness and depression, pst, and also suicide ideation. this wound crippled his spirits. he called it the deep wounding of the soldiers spirit. during this time, he understood that as a warner -- as a warrior he could not walk alone in his journey. in that moment, he helped -- he

asked for help from his spiritual adviser, his chaplain, his family, his therapist, and the american people. this intervention helped pull his life back on the road to recovery. it also became his building block for understanding the inner wounds of war and for ensuring that metal called -- mental health advocates understand their responsibility to leave no one behind on the field of battle. [applause] >> thank you all very much. and when i hear that introduction, have got to tell

you that i get emotional and one of the reasons i get emotional is that when i got one of my blood transfusions, i think i got a little female blood in me and i cried all the time. [laughter] well, just to hear that is just incredible to me. first of all, on behalf of all of those that have served our nation i want to teach -- to take this time to thank you, those individuals here today and those individuals that are back home all over this great nation to tell you thank you for the support you have given me in my road to recovery. i know you have not always heard that, but you are going to hear it from me because one of the things that is so important is that as i faced those dark days at the army medical center, on october 1, 2004, when my leg was taken away, how sad it was that

i sat in that hospital bed not knowing what was happening to me mentally, learning how to deal with the challenges going on, and holistic lee, knowing that i needed you as a support system in my life. ery. i thought about the fact that -- most people say, if it -- if anybody can get through this, is major ed pulido. but those hidden wounds were the ones that would cripple me during a period of time that i just not did not -- that i did not understand. the key moment that i want to tell you that was so inspiring to me when i sat there in that dark place, was the fact that i needed you to support me. you see, as i said at brooke

army medical center, i did not know how i was coined to provide for my family, and that for me was the hardest thing that i struggled with during this journey. when they took my leg, they took so much away, but i also knew that with the help of those service members who had gone before, and those individuals that had made our country what it is today and their service to this nation, that they would get me through those dark days and dark hours and make me who i am today. and for that, i think all of you for what you're doing. suicide for me is something that i faced and i had to talk about it, and it was there -- and it was my therapist, george, and my chaplain that were the instrumental figures in giving me my life back. so as i begin my presentation, i want to narrate my story to you

and tell you that this is one of many stores, but i want to show you how important your support is in making our lives to a successful as we come back from war and we become civilians and we learned that our lives have changed, but in the way they have changed for the better. i would have to begin by talking about what has made this country what it is today. for me, it is about winning. it is about having the service members being a part of a courageous group of people, and honoring our veterans and our service members every time we get an opportunity. they're the ones that provide the freedom, they have -- they are the ones that have inspired me, and they are the ones that we must truly honored each and every day. how great it is that our nation

has been one of service, of giving back, and at times we have made mistakes, but one thing is clear -- in this day an era, one thing i have learned from our vietnam vets is that we will not make those same mistakes again. and this is a prime example of what it is all about -- making sure that the mistakes we made in the past we will not make in the future, and together we can bring change in regard to and how we take care of our service men and women. and i can tell you that this is such a great phonation, and i live in an era where you will remember me and you will honor my sacrifice and help me through recovery. and the thing -- [applause] thank you. and the thing that is so important, as we serve our nation and as we understand

freedom's sacrifice, the reason that i showed you those pictures was because it is so important for me bad as i retired from the military, to have a continued connection. because what happened to me is that at times i lay at brooke army medical center, i am going to be retired, i am going to be out of the military, and i am going to be forgotten. and it was exactly the opposite. that is not what happened. and because of the freedoms and the sacrifices that we have endured, i began my story of what i call challenge, triumph, and change. the challenges sitting on the battlefield almost losing my life. trial is taking the first up after -- triumph is taking the first half after my reputation. and change is learning that with the right support system in place, i could truly a tree

greatness. my story starts on january 27, 2003. after serving 14 years on active and reserve status, i got called up to basically train the new iraqi army. one thing that i understood was that when we go into war, we go as a joint force. and how great it is that i see my fellow brothers and sisters in this room wearing that great uniform, and knowing that as much as i miss it, i could still do my part. and whether we have the army with us, the marines, the air force, the navy, coast guard -- all of us working in that joint environment to ensure that we have the freedoms of this great nation and that we give freedom to nations all over this world. one thing is clear -- our service members know how to stick together and know how to

work together as a team. in that joint environment, you may find obstacles on the battlefield that will impede may be our progress for just a little bit, or those pictures of war and what it looks like. and the reason i show these to the american people is not to glorify this but to say that these are the physical ones that our members come back with. these are the images that they come back with. and whether it is anxiety disorder, depression, hyper vigilance, all of this is clear that when you see these things on the battlefield, at times you bring them back home. and that is one thing that happens to all of us, where the shock and awe of the mission to the tranquillity of what it looks like in baghdad to what we were able to provide for me specifically and those that have served our nation in this great room, whether you have been in

this theater of operation or not, one thing for me that was so satisfying is that we gave the iraqi people their freedom. as i embarked on this mission, i also understood that the people on the ground would also be those individuals that we would begin to develop relationships with. of what may happen to them, those images are forced to live with you each and every day. but also knowing that while we were doing was truly a valuable mission, and whether our politicians did what they are going to do, for us it was about winning and making sure that we accomplished the mission on the ground. and so as we stayed away from the political climate, our job was to provide that support so that they could control their

own country and their run destiny and their own future. one thing for me that is very inspiring is that i understand the value of our non- commissioned officers. they are the reason that i will do the work that i did today. they are the ones that saved my life on that day. i am honored to tell you that because of their work, i am successful because i know i have a goal, and that is to take care of them and not leave them behind on the field of battle. it was my father who asked me to really think about joining the military. the thing that he said to me, a vietnam-era individual, of course, is that you never leave anybody behind in the field of battle. and that is the way that i understand our ngos in the military -- are in ceo's --

nco's in the military. on an ordinary day come monday would change forever. in and ied, which is called a roadside bomb, or improvised explosive device. this is one of our vehicles coming into them picture and what it means to be attacked by the enemy. [explosion] that is what it looks like to be hit by an ied. on that day, i face the challenges -- i faced the challenges that would change my life forever. i got ambushed. and it was so great that those noncommissioned officers on that day took charge of the situation, secure the perimeter, it got me out of that situation

alive, and rendered aid to me. as i sat down at ground on the 103 degree pavement at about 4:00 in the afternoon, the ied having shattered my leg, i had once across the left side of my body. they pulled me out and laid me down. the first thing that 24-year-old said to me was, major, you are hurt bad. by the way, don't ever tell the patient that. [laughter] but for me on that particular time, the only thing i could think about was my little girl. i thought about it if i died on this day, i am never going to see her again. i would hope that you, the american people, would take care of her. and now that you would. they put me on that helicopter 47 minutes later. i arrived in baghdad for 17

hours of surgery. i got awarded the purple heart by general petreaus. let me tell you the most important thing that happened on that day. our leader called my family and told them that i would be ok. that is what it is all about. as i embarked on that mission -- people from baghdad to germany to walter reed medical center. i would end up going to brooke army medical center and spending almost 40 days in icu, a total of 18 surgeries, and this is when i felt suicidal. i want to show you this video, because this is what i look like right after this. >> ed pulido leans on two seeder sticks. he will spend the rest of his

life leaning on his white. nine weeks ago, of bomb exploded. >> it is hard to talk about. i could see through my leg. >> he nearly bled to death, and during the next six weeks, if he wanted to live, he had one choice. >> i lost a leg, but that is nothing compared to losing my life. >> of man who once trained iraqi soldiers in the heats can barely carry a lunch tray at a restaurant. it is unbearable without his wife. >> i cannot things up. >> sometimes he can still feel his missing leg. it will help. >> he said his leg was fishing.

i reached down on the hospital bed and said, is that better? >> what you going to get dad? >> of ft. -- 8 ft.. -- 8 ft.. >> it is a smile -- a foot. >> it is a smile that says everything will be all right. she is saying, san antonio, if you missed it. that is where kaitlyn and mom are driving? so that he can be fitted with a prosthetic leg. >> it is the hardest thing i've had to go through, but i'm going to do it. and to learn to walk again, with the two most important crutches,

his girls. a time of the war decided to keep part of toledo. -- pulido. >> as hard as that is, that was suicidal for me. it was dark and very troublesome. but it was the american people and the support of those individuals that had come before me, those service members that had been wounded critically and given so much for our freedom that really were the inspirational figures in getting me through that situation. one thing that was clear is that they taught me that there would be some outlets for me to regain my recovery back. one thing i did was i went snow skiing and i actually got to play with the para lembeck a --

paralympic hockey team. it was great to be around all these individuals that had been disabled and to know what my next up in life would be. -- i had my god with me, my family, my community, and in order to continue to give the bacback i d up with a commander, and a way for us to give back to those who served our nation, we decided to work and embark on a foundation that would provide scholarships. how great it is that we can honor their memory, educate those individuals that have sacrificed so much for our freedom, and understand that we cannot do it alone. the government cannot do it alone. it takes a community, and it

takes everyone coming together to make a difference in the lives of all of those who served. and by bringing these key partners to bear, what we're doing is changing lives, working with the va, working with dod, and so many people did get these individuals out of the golf courses to do the things that they can be inspired to do. mental health recovery is possible because we are able to provide this. my time has been cut short ta today, but i can tell us that our service members have given so much. you are here to provide that support to them. it was interesting because i must tell you that when i was at brooke army medical center, it was general peter pace, the former joint chiefs, who was my inspiration that at a moment time when it was so dark in that hospital room, and i will always

remember what he said to me. he said, "major, always remember that on that day you did not lose your leg. on that day you sacrificed it for your country and for everyone in this nation to be free." today we're here to make sure that when our members come back, that we do not leave them behind for it "would you sacrifice? would you sacrifice your time, your energy, and i ask you to do that, but i also ask you to make a difference in the lives of those that had given the ultimate sacrifice. the last thing i will tell you tis thank you. god bless this great nation. and i salute you. [applause]

>> listen gillan, please welcome the chief medical officer for veterans affairs. -- ladies and gentlemen, please welcome the chief medical officer for veterans affairs. >> good morning. it is a deep honor and gives me great pleasure to introduce the guest speaker. a 1965 graduate of west point, secretary shinseki completed 38 years of uniformed services in the u.s. army, including two combat tours in the republic of vietnam, and served as the army's chief of staff from 1999-

2003. secretaries shinseki became this secretary of veterans affairs in 2009. ladies and showman, secretary of veterans affairs eric shinseki. >> thank you all very much. they're kind and a very warm welcome. they give for that introduction. short is always best. i am honored to be here. secretary embrey, good to see you. general sutton, great to see you as well. fellow veterans, other distinguished guests, welcome. let me thank secretary gates for

hosting this very important conference on suicide prevention. and then for having the great generosity to allow ba to partner with dod -- va to partner with end. i like to thank ellen embrey for all the work that she is done for so many years strengthening the military health-care system. alan and i overlapped this week as i was finishing my time in the army, the early days of iraq and afghanistan, and it is great to see where you have taken all this. the very best to you and thank you for your leadership in your service. i appreciate this opportunity to address your conference. throughout my years in service in uniform, suicides were one of the most frustrating challenges

i face. as i ask mostly of myself but others from time to time, why do we know so much about suicides but so little about how to prevent them? why do we know so much about suicides and still know so little about how to prevent them? a simple question, but we continue to be challenged, and for that reason i congratulate secretary henry and general sutton as well as my people, and others who are here, for the wisdom of this conference and for their efforts to address the serious problems related to -- and i am speaking of the noncommissioned here -- related to the loss of self-worth and self-esteem and how such fragility can lead to acts of self destruction. of the more than 30,000 suicides in this country each year, fully

20% of them are acts by veterans. that means on average, 18 veterans commit suicide each day. five of those veterans are under our care at va. so losing five veterans who are in treatment every month and then not having a shot at the other 13 who for some reason have not come under our care, means that we have a lot of work to do. who is vulnerable? everyone. young and old, al gore and reserved, male, female, officer, and listed, me included. will your suffer emotional ones just as they suffer physical ones. -- warriors' suffer emotional wounds justice they suffer physical ones. i am preaching to the choir

here. emotional injuries do not lend themselves to physical fixes, but we must continued to -- one of those splints and patches to help us with the emotionally and mentally injured? when a lot of the causes of suicide, from physiological three dispatchers -- physiological predisposition to those "dear john" letters. recreating the last 721096 hours of a soldier's life was so instructed. where did they go, what was said, what did they do it? a case study usually revealed of multiplicity of signals regarding the individuals intent.

company makes, friends, and other units, spouses, significant others, barkeeper's downtown, friends and family back home, all were gifted with a piece of the puzzle. and not until all the pieces were collected, and usually in aftermath, was the picture completed and signaling what was quite clear. you know that and i know that. the issue is, how do we get better at this? this audience of health care providers, counselors, researchers, and community partners constitutes in military parlance -- i did i get to use it anymore but in your parlance -- our main attack against suicides. you are the experts. you dispense help and hope to those who see themselves as helpless and without hope. i do not think anyone of us can do this alone.

if we could, we would be further along. and all of us here today may still not be enough. as this case studies always informed, there are many other witnesses to the key indicators and pre-suicidal behavior. we are in this together to help the most vulnerable of our people, those in uniform and the veterans who come to us. and as is true of most organized team activities, it is usually better to be on offense than defense. it was about act, react, and counterattack. we tried never to take that first that of acting without knowing what we were going to do in that third step, when counter action was required. that is usually the way that actions go. act, react, counteract.

we must build and maintain a strong support system, one in which everyone has a role, where we collectively assume ownership of the problem. it is not someone else's problem. it is our problem. it does not matter whether there is a uniform or not. it is our problem. we own id. i think the sense of ownership is a critical aspect of the solution. it increases the level of awareness throughout our communities. and in this regard, the military services probably have the edge in compelling ownership by virtue of their highly structured responsibility for reporting and accountability. i used to recall that, and that is what this case studies were about. everyone knows -- everyone knew who owned the issue. it used to be that studies were

done to pinpoint roots causes. unit buddies, family members, friends, in a manner of hours, the last hours of someone's life were recreated as best we could and reviewed, and all too often to the pieces of the question why were collected, it was clear that the warning signs were there. always there, but were messed or not acknowledged in fear of interfering with someone's privacy. that was my experience. to counteract that tendency, training programs like operation save urged participants to get involved and be empowered to do the right thing when they suspect someone is at risk for suicide. speaking for my current role at thva, i think we need to do

that which the military has learned so much from. we need to raise awareness of suicide indicators, not just in our patience but amongst our work forces as well. how do we foster and obtain the goodness of the buddy system that has helped so much in the military and apply it in va among a population of 7.5 million that is all at once disabuse -- diffuse? i believe that it can be done. it may be best and some specific suburbs, those pockets of new veterans now clustering at colleges and universities all across the country. i was just down in florida and i was just down in florida and got a chance to

i was just in florida and got a chance to speak to some student veterans that were going to school on the new gi bill, about 20 of them. by the way, usf plays pretty good, but they have 10,000 veterans registered for school. i got to talk to about 20 of them and primary interest was talking to them about the journey they were on. i said to them, you know, you are all carrying baggage. immediately, i got this push back at the table. it is great to see 20-year-old set -- 20 year-olds react to a 60-year-old's comments. [laughter] icet, you are carrying baggage and i will tell you, we all do.

we all did. you came from a very structured environment where there were first sergeants and company commanders and detachment supervisory people, and now you are here and you are on your own. you are going to have to figure out how to take care of each other because, you see, while we are all celebrating you being here on the first day of school, i am looking at graduation rates. if you do not graduate, there is no payout for this program. and you are carrying baggage and you're going to have to transition through this. how many of you do your best work after midnight? you come awake about 1:00 in the morning in your powers of concentration seemed to better because you have been dozing in the early hours? maybe one hand went up. how many of you draw your shades in your room down to the windowsill?

everyone of them, there is no gap of light. a couple of hands went up. how many of you have anger management problems? a couple of more hands. how many of you have to read the same paragraph three times before it begins to stick? just about every hand went up. [laughter] i said, welcome to the nfl. you are ok. it's just natural. it is a transition that you will have to go through. it will be helpful if you do it together, help each other. and by the way that youngster not making class, somebody figure out a way to get down the hall, kick him out of the bed, and get in the class. graduation -- that is where i am focused. the old ways of approaching -- approaching mental health and

suicide prevention will not work as effectively for the youngsters of the new millennium. i am not sure what that means. but i hear that enough and so i repeat it for you. we are being attentive to that. they are different from those who came before, and i can tell you that as well. most were born a decade after the last shots were fired in vietnam. they had never used to dial telephone, never watched a black-and-white television, and if you gave them one of those old fashioned can openers, that would probably try weeding your garden. they've never known a world without cellphones, the internet, and is testing -- instant messaging. they talk and act fast because they grew up that way. and so we have to adjust. engaging them requires a new and different model. no longer a desk at an imposing

government building but at coffeeshops and on the internet and to a public service announcements they sealed off -- see on a flat screen television or a web site transforming into a less formal, more open format requires greater collaboration, transparency, and in both our services and our service delivery. i am speaking of an environment where mental health issues in general are demystified, the stigmatized -- the stigmatized -- destimagized, or asking for help as a sign of courage, where there is high quality care, what -- where we identified those with highest risk and do something about it quickly, where emerging treatments and technologies

coupled with new drugs advance the success of patient outcome. it is the outcome that we are after. where they do not feel ashamed by there are emotional problems. and where research is complementary and alternative treatments so that we may determine what of the safest and most effective in relieving suffering and restoring health. how does all that translate from theory into action? we take them to heart and -- in a institute of medicine's 2003 s study calling suicide i national imperative. that drives our overall program as well as the actions we have taken so far and the ones we will take in the future. it is had far-reaching effect for us the inside va. we have expanded our work force enormously, hiring more than 4000 new employees in the last

three years, bringing our total mental health enrollment to about 19,000. 400 of them are dedicated solely to suicide prevention. each of our 153 medical centers and the largest of our 74 outpatient clinics now has a suicide prevention coordinator. it ensures that are at risk veterans receive counseling is a priority. we have extended our outreach to veterans, which in itself has significant life-saving potential pre part of that outreach effort can be seed in a nationwide advertising that some of you may have seen, the campaign on city buses and commuter stations, raising awareness about 24/7 suicide prevention lifelines. we have opened a center of

excellence will help center in new york -- mental health center in new york, nice, warm, sunny new york. [laughter] there we felt this on testing intervention standards for suicide prevention. at our new research center in denver, we are studying the clinical and biological conditions that can lead to increased suicide risks. most notably in 2007, we dramatically improved our prevention program by launching a national suicide hot line. many of you probably know about this but for the few that may not, let me tell you that we partnered with hhs to strengthen our seamless/dod relationship. the opening message on the hot line welcomes both veterans and service members to access nd services.

the hot line are mental health professionals. they do not discriminate between uniformed and non-uniform, and neither do we. we introduced a chat room for this young degeneration designed to appeal to them. we must continue to leverage opportunities to access and intervene to save the lives of those in distress. after all, there is a standard protocol at every hospital for heart attack victims to come through the doors. there is an established protocol for what you do from the moment that that person walks through the door for it why should potential -- why should some potential suicide victims not be afforded the same thing? dr. janet kemp is the brain

behind these initiatives. the partnership for public service presented its 2009 federal employees of the year award for anticipating the emotional toll was likely to come from all the stresses and a high risk environment that our young combat veterans have gone through. janet, once again, thanks to you. [applause] the people that owe you the biggest vote of thanks are the 5600 or so people who have called in. there are many more that have called in, but there 5600 of them who are in crisis, thinking about suicide, and interventions occurred and they are still with

us today. they are the ones that really demonstrate what you have accomplished for less. -- for us. there is no clear-cut -- i have talked about all the things that were attempted. you will ask how we are doing, and my answer to you would be, we have only just begun. there is no clear-cut answer here. even as the issue of self destruction becomes more complex and changes, we have to adjust. our initiatives are new. we do not have enough hard evidence yet but we think we're headed in the right direction. we can take heart that some of the early emerging trends are encouraging and the data. we know, for example, that since the start, suicide rates have increased -- decreased and veterans that have come to less for health care.

the five veterans that have -- that we lose, there are many more that are coming to us for treatment and are suicide rates who are under our care, those rates have come down. that is a good sign. and despite public perception to the contrary, we do not have any evidence for increased suicide rates among these veterans relative to the veteran population as a whole. where do we go from here? in large measure of this conference, it will help point the way. that is why you are here. deliberations will provide direction for strengthening our current programs and for helping us understand what new programs may be necessary, new programs that are innovative, forward leaning, and with the community base that we operate. the real heroes are those out there in the community that

touch our people, and yours and mine, every day. in conjunction with conference of the faculty and staff, you would give us the benefit of your knowledge and experience in confronting suicide. suicide risk, and leveraging its prevention. i know that by sharing this, both departments, both defense and va, stand to be better positioned to aid the men and women who are struggling to regain the courage to live. struggling to regain the courage to live. and so i am honored to be here and privilege to share this opportunity with ellen embrey in opening today's conference. you have an important and ambitious agenda before you. thanks to all of you for participating. did you for having me here and my great respect -- thank you for having me here and my great respect for the previous

speaker. i caught the tail end of his presentation. god bless each of you and each of you who has served our nation, and may god continue to bless our wonderful country. thank you all very much. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2010] [applause] >> now available, c-span's beaupre, "abraham lincoln: great

american historians on our 16th president of." it is a unique and him -- and a contemporary perspective on his early years to his life in the white house and his relevance today. and abraham lincoln in hardcover add your favorite bookseller, and now, on digital audio to listen to any time, available where digital audio downloads are sold. learn more ad c-span.org /glyndonboolincolnbook. >> create a 528 minute video on one of our greatest strength or a challenge the country is facing. it must incorporate c-span programming and show varying points of view. and your before midnight january 20. winning entries will be shown on c-span. do not wait another minute. >> a live look at the u.s.

capitol hill where the house is about to gavel in for a short pro-forma session. members will then recessed until 6:30 p.m. eastern when a roll call will take place to establish a quorum, part of house rules to get the session -- the second session of the 111th congress under way. now live house coverage here on c-span. the speaker pro tempore: the house will be in order. the chair lays before the house a communication from the speaker. the clerk: the speaker's room, washington, d.c., january 12, 2010. i hereby appoint the honorable dave p. moran to act as speaker pro tempore on this day. signed, nancy pelosi, speaker of the house of representatives. the speaker pro tempore: and now the prayer will be offered by our chaplain, father coughlin. chaplain coughlin: as the 110th

congress reassembles to meet its constitutional commitments in its second session, may the prophetic cry of israel from the prophet be heard in the hearts of all members and in the attitude of all america's people. as the lord has called you for the victory of justice, i have grasped by the hand. i formed you and set you as a covenant for the people, a life for all the nations. accomplish great deeds in and through us, lord, and make these days a time of great promise and fulfilled blessings . amen. the speaker pro tempore: and now pursuant to clause 12-a of rule 1, the house will stand in

recess until approximately 6:30 p.m. today. om the app store. host: will be talking for the next 45 minutes about the 2010 congressional agenda. first off, drew armstrong of congressional quarterly -- you have a headline here.

the final version is likely to include a modified version of the senate's tax on high-cost insurance plans that union groups would like to kill. it may also reflect the house as preference for boosting taxes on the wealthy. tell us about the struggle that will happen when both the house and senate get back on. health care on guest: we have a situation where the house and senate raised hundreds of billions of dollars of revenue. the house relies exclusively on taxing wealthy americans. many liberal democrats prefer that. in the senate the biggest raiser is a tax on the highest cost, essentially the cadillac plans. it is pushed by economists, health care and some wonks of the white house.

it would levy a tax on insurance companies that offer very high cost plans. unions hate this because many of the members have this, especially those who have a worked to -- the work in dangerous professions or have sacrificed other pay court over the years. they are turned to find a compromise on dealing with these two revenue proposals. at the end result is probably a little of each. the tax on high-cost plans could be changed a little not having as many. i think it will borrow some of the money from taxing some of the richest americans. host: david lightman on friday you read that congress is working down under the pressures of a number of rapidly changing political dynamics.

guest: i think it already has affected the bill to some degree. congress is changing as it always has, but this time because of technology. the internet, the 24/7 news cycle, the ability of members to communicate back come instantly. particularly the u.s. senate which was always called the world's most exclusive club, and kisses on club. members got things done by making deals. going into the room until 4:00 a.m. and returning with it% of what they wanted. many of the best deal makers are going or gone. last week when dofgin and dodd said it would not reelect -- seek reelection, that was 48 years gone. senator kennedy's death was a huge blow. senator biden to become vice- president of these people came to the senate before c-span even

begin to televise dealings and before there was c-span or twitter. there was a different kind of negotiation and congress. i am not saying one is better than the other, but that the changes happening fast. host: will the changes to allow the negotiations to get through and rapid amount of time so congress can move on? guest: drew would confirm this and that it depends which hour you asked me this question. i was convinced that we get this done by the end of january in time for the president to get ready for his state of the union address. it is not just technology. it is such a huge, complex issue. the closer that we get to november and the elections the tougher it will become. it will be done, but i don't know when. host: you write that the will be no formal conference and instead

lawmakers have agreed to work out the final bill in private. how long do think this will take to get the deal done, and is the white house would in for some kind of signal that yes, we have. a final have you can schedule the state of the union address? guest: david brought up an interesting point as to when things will get done. i have learned never to trust my own opinion. the goal is sometime near the state of the union, likely in early february. in reality, they will be ready when they are ready. it will take a few weeks. i know they want to get it done as quickly as possible for

political reasons. november is a long way off, but not in their minds. they 1 to be done with it, but there is a lot they must do. it is not only about crafting policy compromises. they have to sell to their caucus and both the senate and house, then returned to ask if it is ok, then return to negotiators. going back and forth takes a lot of time. guest: here is where the 2010 congress advantage differs so much from the congress of only nine or 10 years ago. in the past leaders would not necessarily muscled through something like this, but say this is what we will do. not take it or leave it, but the leadership would say this is what we're is-- play a game of chicken -- and there is still

some of that, particularly in the house. i think the leadership will eventually have to do that, but the problem now is every time they make a suggestion or that there is a new once it gets reported instantly. look at the health care tax. last week the president said he wanted the senate built with the tax in it. yesterday leaders met and were not quite sure. this would have been done in private before. it is still done in private but somehow we know every step. that changes the dynamic. host: drew, you write that there will be no formal conference. does that mean for fans who like to watch the process and to turn into c-span and other media that there will be nothing for the cameras to report? guest: if you look at the historical number of conferences over the past years there have been fewer formal ones.

even when there is one of the real do making getting done gets done behind closed doors. when everyone is in the room and can be harder to work on the deal. they will make a mini conference within the comets and go back to negotiate, then bring it back to the full conference. the reality is, folks like you and me and david are never going to be in "the" room when a lot of this happens. we can hear about it, but it is very rare that you would see the public dealmaking that goes on. the plan right now is for no formal conference. there will do what they call ping pong. the will be a deal worked out in private. the senate will cleared for the

president. they want to do it that way because it will be faster. host: the 2010 congressional agenda is our topic for the next 35 minutes with david lightman and drew armstrong. the first call comes from holly springs, mississippi, just south of memphis. caller: good morning to everybody. my question is, will there be any solution of the electronic medical records to cut the costs? i support healthcare, although i have voted in the republan party. i supported the senator who abstained from the last senate vote. i was proud of that because he has a lot of constituents in this area who need health care. there are many people in that so-called donut hole.

is the deployment of the electronic medical records coming on line soon? host: david, you touched on technology earlier. guest: that is one of the few areas where they tend to agree. you need to make it easier to get the medical records online. so you don't carry a folder from physician to physician. host: maurya from washington, d.c. caller: [unintelligible] we need is universal health care. they're negotiating with the different industries behind closed doors. we the public deserves to know

what it is going on. i don't want watered down healthcare. that is what is happening. the unions sometimes get no increase because we get a better package of health care. i support the administration. we need to know what is happening. they should allow c-span to go to this hearing. host: how much love back do think there will be in november 2010 when the elections come up, even if it is just a perfunctory exercise if they do all this negotiation behind closed doors?

guest: it is really hard to say and will depend on a wide number of factors. despite the fact that this is done behind closed doors if it is a relatively open process resulting in a product people can understand, then the blood that would be minimized. -- the blowback would be minimized. i think it would be minimized. on the other hand, if they cannot with a totally rewritten bill that people are shocked by, then the reaction will be that it was negotiated behind closed doors with no idea what would be in there -- then, yes, there'll be reaction to obama's promise about having c-span in the room.

it will be decided by the context. more so than by the actual process. host: john, glenview, ill. caller: i would like to discuss two issues. the first to do with a cadillac @@@@@@@ @ @ @ @ @ @ @ @ @ @ @ @a it's a shame what they are calling the cadillac plans. i am in a situation where you have a couple of options three options in my case from one insurance company, the company i worked for has contracted with. and the quote-unquote cadillac plan pays for everything. but the -- there is no plan which most people would be happy with that covers the 80%, the next year -- that the next year down covers. plan that covers

that and still covers 100% catastrophic. if you get $20,000 bill that will ruin you. the other thing i would like to address quickly is the republicans continually bringing up the one of their options is bringing of options, competition across state lines. this is an idea brought on by the insurance companies because selling across combine across state lines in competition means you can sell across state lines and do with the banks did which is then go to the state or one or two states that offer the fewest consumer protections -- you think of moving to china is easy? moving to another state is

nothing. the insurance companies will go to whatever state gives them the best deal. there will not be a plan in oregon or michigan. host: please address his concerns. guest: here is the more central point. i don't want to say that the caller is confused, but has many important questions. we get this all the time. it is very difficult to say, ok, we'll take your individual case. we are not insurance experts. part of the problem which every poll shows is that people do not understand what is going on. if you look at the pew research from last month the figure was in the high 60s as to the number of people who do not understand this, up from the previous month. there are couple of organizations that have it easy to read charts that we refer to, for example the kaiser family foundation. it compares the senate bill in

late terms. cq and a mothers have been charged. that is the way. you have to look at that and figure it out and then call your member of congress. then ask how relates to you. host: drew armstrong, took about the concerns regarding competition between the states. guest: one of the things that will be in this bill almost certainly is the idea of an exchange for people who do not have insurance will be able to buy a variety of plans through the state-based or nationwide based insurance exchanges. it is a point of debate in the senate. the house has a nationwide based insurance-based plans. it would be federally organized. it will not be federally regulated. essentially the oversight and process would be done on the federal level.

the senate bill does it on the state level. the argument by those in the house is that on the federal level you can hold insurance companies more accountable with tighter controls. . . congress is also looking at jobs, among other things. "priority number one means keeping the economic recovery going," says maryland representative chris van hollen. chairman of the trattic congressional campaign committee. "we can't allow the gradual

recovery to sputter out." what does this mean congress will be doing in the coming months in terms of jobs? host: when -- guest: they were all saying we need to do something to show people we care about the economy, we're going to create jobs, we're going to get them back on their feet. health care, they said, is not what they're hearing back home. it's a concern no question, but what people say, what are you doing about the economy? i tell you, there's almost this feeling out there, gosh, let's get done with health care so we can get moving on jobs. they're eager to do that. the house passed a $155 billion package back in december. the senate is now considering that. it has a number of potential job-creating mechanisms, including more infrastructure investment, extensions to unemployment insurance in certain hard-hit states and so forth. the minute they get on health care if not before they are going to be focused on jobs.

if wouldn't shock me if there is a jobs package out of the senate by washington's recess by mid february and probably by the spring recess in i think march 25 or so. host: drew armstrong, will the senate be able to work on this senate bill before health care? can say, excuse the phrase, walk and chew gum at the same time? guest: yes, but they want to make this bill about health care. they said the health care bill could create 4 million new jobs. they are trying as much as they can to make it a job to issue. they have done this for awhile, actually. one other interesting point that david brought up, there is not as much focus on health care back in the district. there was a town hall over the

break. it was notable that over the august recess, five months of, some of the town halls he was holding, people were upset, there was yelling. yesterday, he said people were interested, but nothing like august. for some, the shift back at home has been worrying more about jobs. host: back to the telephones for our discussion about the congressional agenda. idaho. sean on the republican line. caller: it seems to me if people are able to buy insurance across state lines -- insurance

executives say that there would be a race to the bottom with the cost of insurance. it seems to me, if that is the case, companies would be flush with money because they would not have to spend so much on insurance for their employees, and then they start to hire more people and invest more. that is all i have to say. guest: it is tough because reputable people, professionals have been widely varying differences of opinion on this. that is why we rely on the congressional budget office. they are non-partisan,

independent, and i would encourage the caller to visit their site. i am sure you have solid, reputable people on both sides and you walk away thinking, and i do not know what to believe. host: new jersey. jack on the independent line. caller: i am so disheartened by health care experts like you. i cannot understand how the united states is spending twice as much capita as any other country in the world. whether it is a single payer,

like canada, or countries with universal, regulated insurance, such as the netherlands, switzerland, and we are still paying twice as much? i can only contribute it to the fact that our congress is so financially corrupt. host: drew armstrong, help jack understand this. guest: he is right, on a per- capita basis, we spend more money than just about any other nation, and we get less. from a financial standpoint dancand care standpoint, our heh care programs are disappointed. -- disjointed. part of that reason is because

we do not have a centralized health care system. ed we are going to be bringing people into this quote-unquote system. the idea is to eventually get that per capita spending down substantially. there's a number of reforms in here that the long-term effect which we don't know just yet but i think are going to have or i think a lot of us hope will have some effect in driving that down, making this more of a system, making it more efficient. there's a lot of things in terms of care coordination.

one example is, you know, the hospitals, there's going to be a penalty on hospitals that would readmit patients for things they shouldn't be admitted for, things like that. making sure we aren't doing procedures that don't need to be done. paying for procedures that work better and not paying for procedures that don't work as well. there is things to drive down per capita spending. the flip side is to bring these people into the system that will cost a lot of money. millions of people. that will cost millions of dollars. host: one of the other issues that politico is highlighting on the 2010 and and it is deficit reduction. they write --

david lightman, can we spend the money on health care insurance and get people back to work, and reduce the deficit? can goncourts' to do that -- can congress do that? guest: i feel like i have been writing this story for about 30 years. a few years ago, they tried to start a health commission, and there were some problems. often, health care does on follow standard economic models. if my car is breaking down, i go shopping at the dealer, in the newspaper. if i feel pain in my chest, i cannot go to shop around. i will go to the doctor.

chances are, he will ask me to do a bunch of tests. and as the cbo pointed out, it is impossible to know what kind of technological advances will be available. we do not know what types of procedures will be there. having said that, it is hard to tame the deficit. not to sound cynical, but we have witnessed the death. to pass the budget we have the past 12 appropriations bills. in october, they passed a stopgap for more on the government in december. is that responsible spending? stop nafta goes through the year. there is a process that everyone

said they would follow. the president said it would not be as usual. host: back to the 2010 agenda with drew armstrong and david lightman. bearing in florida. caller: -- barry in florida. caller: insurance companies have @ @ @ @ @ in the meantime, the nontax issues is something the insurance companies used when they went around to unions and others to sell health care because it was nontaxable. so then you come to the problem you have now where you have to raise money because now we are going to cover all of our citizenry. now the solution has to be, how do we phase in a tax or phase

out the tax that the insurance companies have had the benefit of using for all these years? so my thoughts are, first of all, pass on -- tax on health care shouldn't be. it should be fair to all of our citizens. you can't have some people don't pay tax which is a situation now for health care and others that do. so that's the view i wanted to make is whatever you do make it fair and across the board and undoubtedly if you do decide to tax it because unions had to go to the collective agreements and so on to negotiate coverage for the members, whatever you do now you have to take that into consideration and be fair across the board. int guest: he's talking about the wide exclusion of pretax dollars. and the cadillac tax is

actually vastly scaled back version of an idea that a lot of health care economists and health care politics were pushing for at the very beginning of this process, especially on the senate finance committee where a lot of the very complex policy was written. tax is an economic tool, and a lot of ways. if you put a tax on som if you put a tax on something you create downward president bush on its costs because it has pressure not to do so because it's a tax benefit. there were a lot of economists arguing that you should start universally start taxing health care benefits, do not make this pre-tax dollars. the idea is it would make people more sensitive to the cost of their health care premiums, companies would put more cost into wages, fight harder with

the insurance companies to drive down cost, and the result would eventually be economic pressure on a lower insurance premium. this, like tax is basically a sliver of that, taking the most expensive plans and making them subject, indirectly -- because this is a tax on the insurance company, not the premium -- indirectly to improve the economic effects. does this agee the desired economic effects? the cbo says, to an effect, it does. host: next phone call. caller: senator mary landrieu approved this book she also conferred with gov. bobby jindal who used to be involved in health and human services in the

bush administration, so he is familiar with him -- the health debate going on. is this something the governor makes? would it be put to the state to vote on, if they wanted to opt- in? host: david lightman? guest: opt out was a part of the plan that harry reid introduced. what we have now is a plan where the government would supervise a multi-state plan, one of which would have to be nonprofit. this would provide competition with private insurers. host: next is ron from syracuse.

independent line. caller: i am not really interested in health insurance reform, regulation. i do not think we need health insurance, we need health care. the gentleman who called in and while ago said he could not understand why a our costs are twice what other countries are. the answer is we treat health care as a commodity, rather than a right, as everyone else does. from 2000 to 2008, costs went up 128%. health-care costs did not go up. nurses make an extra 3%, hospital staff. but from 2000 to 2008, the 10

top insurance companies increased their profit 450%. that is where the extra money goes. we need a single payer system. we need health care, not health insurance. host: 01 to move this discussion out of the realm of health care, regarding the 2010 agenda. politico writes about climate change and immigration reform. they might -- write -- drew, your thoughts about climate change, immigration reform, and whether or not congress will get to them before the midterm elections, or if it is something that we will have to wait for until after 2010? guest: i will take part of this

over to dated who knows these issues better than i do. can they do jobs at the same time that they do health care? to some extent, health care is going to be the dominant issue for congress, particularly when the entire caucus is involved. until they finish that, they will be able to deal with some priorities, including jobs, but major policy decisions will be put on hold until they are finished with health care. climate change, immigration, some other top issues, that could be a better question for david. guest: climate change cleared the house in june. now we are in january and there is no talk. they are barely getting 60 votes on health care.

forget climate change. i think the issue that will come up that was not mentioned, in the spring and summer -- this is going to be a hot one -- financial regulation. people back at home are angry about the banks, mortgages, the financial system. senator dodd is moving a bill through. the committee may even write the bill before the month is out. everything they do this year will be specifically directed at being able to go home to tell people, here is what i did to help you through this economy. 1 host: 2010 -- host: 2010 congressional agenda. next phone call. democrat line. caller: it is a sad state of affairs. we have the most uninformed

public. all you have to do is repeating a phrase three times and they will bring it back to you. we should be looking at the media who seems to be making the decisions, clarifying, instead of waiting to see what our representatives say. especially c-span -- what i would like to do is to have publicized what is in your production meetings before you decide on your questions. why didn't you do this when you wanted to publicize the supreme court? you did not go public. you went public, but you did not push it the way that you are. host: are you talking about the letter that our management wrote to the folks on capitol hill? caller: yes, the way that you

have been stealthily challenging everything. host: actually, we have gone on record asking them to open up court proceedings. caller: let me tell you something. you have a powerful platform. people call in, and you cut me off. host: i did not cut you off, but if you are done with your point -- next phone call, scott from new jersey. caller: the bottom line of the government is inefficiencies. i may have a unique perspective and that i am a veteran. i also spent some time in the v.a. hospital system, so i got to experience the government-run

military experience. i do not care what anyone says -- i have heard some call in to say that it is wonderful. i do not know what they are talking about. it is the most inefficient system. i also worked for state government. i currently work for the federal government as a contractor. what people do not understand is anything the government pledges becomes massively inefficient because they piggy bank special interest. it is absolutely insane the amount of money i see. i am on a contract with the department of transportation here in washington, d.c. and i am shocked at how much money is wasted. people do not think twice about it in the government because it is not their money. host: drew armstrong, is the

congress going to do anything to address these concerns about government inefficiency? guest: you will certainly hear about it. hostcomplaints about government inefficiency are not exactly new, nor are they on warranted. -- unwarranted. there is massive amounts of money involved in this. we may be disappointed, but i do not think there is any abject shock in this. guest: one piece of good news goes back to what we said a few minutes ago. because of this transparency, the 24 hour news cycle, a lot of these hearings on capitol hill that might have been ignored in the past are now on different c-

span channels. there is more accountability, transparency for this stuff host. host: and we did not pay david lightman to pump up the network. next phone call. west virginia. caller: one thing i do not understand is, you talked about jobs. one reason it is an issue is because it is a global economy and we are trying to compete with businesses who do not have to pay for health care. why not take health care out of the business community and put it into the credit community? have mass numbers of people getting insurance together. if you are a small business, go in as a credit union. caller

how come they do not do anything like that? guest: in the nation's health- care system, for better or worse, has evolved as an employer-based system. there has been a lot of discussion about single payer. i believe in the senate they took a vote on the idea of single payer and the support is just not there. host: in the "financial times" there is an opt-ed that says bankruptcy could be good for america. he says --

andrew armstrong, at the end o which one of those is will be tops on congress's agenda? lower taxes, social spending, war funding of the military machine? guest: if i could be blig, both. heading into the -- glib, both. heading into the 2010 year, not all what is going to be done. they will be campaigning. there will be talk about lowering taxes, talk about funding the troops -- all of these things. we are going to be back into

promise season pretty soon. how much of that is an act upon after the elections is for question. democrats feel like they have a lot of pressure on them, but poorly, and after they deliver -- they hope -- on health care and jobs, that is going to be what they run on in 2010. the outcome of the election will determine what can be done. guest: i think what will happen is the president will propose his budget for fiscal 2011. that begins the first week in february. that will trigger the budget process. you are going to have hearings, votes, to route the spring and summer on the military, social spending, low energy income assistance.

you will have a series of these fire fight, and that will be the lead up to the campaign. defense -- they did not finish the defense bill until mid-2007. i cannot imagine that happening again. i think it will be done by late summer, early fall, saying, look at what we did for the military. host: next phone call, david. -- eric. caller: this is a moment of catharsis for me. i am a town holler, the better, and i am angry. congress has the power to tax income but they do not have the power to limit it. that is what the 15% tax is on the overhead profit in the reid bill.

i have a class action with two plaintiffs currently receiving medicare advantage and they are angry at the fact that there will be people in florida who will continue to receive it, and that is arbitrary and capricious actions creating two classes of people, and in violation of the constitution. host: we are going to leave it there because we are running short on time. this concern about taxing income? guest: he brings up a component that is in both the house and senate bills. they are calling into a limit loss ratio. essentially, there is a limited amount that insurance companies can charge for premiums, for anything other than what is going to patients. yes, that is a profit limit on

insurers. that does not mean they cannot derive profit from other areas, investments they made. but in terms of actual premium dollars, there is a limit to the profit they can take from that. guest: he talked about court challenges. i wonder, if and when his health care passes, if this is more to end up in court and we will have court challenges for months and months. thank you very much for being on the program. >> thank you. >> democrat jon corzine makes his last state of the state address to the legislature in trenton. you can watch that live coverage beginning at 2:30 eastern here on c. and later, a briefing on the

reallocation of the broadband spectrum for emergency personnel. that's live at 5:00 p.m. eastern also here on c-span. >> now available, c-span's book "abraham lincoln:great american historians on our 16th president." from 56 scholars, journalists and writers. from lincoln's early years to his life in the white house and his relevance today. "abraham lincoln" in hard cover or your favorite book cover. in digital audio where audio downloads are sold. go to c-span.org/lincolnbook. >> the deadline is coming up for c-span's student cam 2010 documentary. top prize $5,000. just create a five to eight-minute video on one of our country's greatest strengths or a challenge the country is facing.

it must show varying points of view. winning entries will be shown on c-span. don't wait another minute. go to studentcam.org and upload your project today. >> now, democratic michigan representative bart stupak host a town hall meeting. among the issues discussed, proposed health care legislation. and he also takes questions from constituents. lawmakers across the country are holding similar meetings this month. this one is about 90 minutes. >> it's always good to be back up here in the copper country and we've been on a swing here this whole week throughout the western end. i wanted to wait some time to do town hall meetings. i've always done them throughout my career. i still enjoy doing them. we left on monday and making the swing through. we'll go down to iron mountain and get home late tomorrow night with a bunch more meetings. we're back in washington on monday. before we get started, hopefully you sent off that orange card when we do town

hall meetings. one way to contact you. turn those back into the back table back there and we'll keep you informed. there's a new line on there, teletown hall meetings. i've been doing more. as you know my district is half the state of michigan, 600 miles from one end to the other. my next teletown hall meeting will be the first week in february. and what we do is we have a vendor ask about 35,000 people. i get on there just like i do my regular town hall meetings, say a few words and then open up for questions. i do that. another way to stay in touch with everybody with a strict that's half the size of michigan. i could hit all 31 of my counties at one time. and while you're down in standish, you can be pardon of that conference. we are looking ways to reach out, informing people, keeping individuals involved. with me tonight is district

administer. he's in the back. if you want an issue you don't want to bring up in anything, a veterans issue, a social security issue, i'm sure tom will take down your concerns as you know we do a lot of casework in my seven offices that we have throughout the district. amy is we me. she runs my holton office. -- my houghton office. casey works with senator stabenow. if you want something the senator to address i'm sure he can take those issues back. i give you a little update. since we've been doing a lot of work on health care, that's been the main focus. besides jobs and the economy. i have a powerpoint. seldom do i -- the only other time i've used a powerpoint is when i use health care. i want to say a few things, what's going on. where i see what's going on with health care, the economy, jobs. and then we'll open it up for questions. i did set aside an hour and a

half. we have a big crowd here tonight. we have a lot of people standing. so when we get the questions, i'm going to ask that you ask a question and be respectful of everybody. a lot of times at town hall meetings, people want to give up and give a five-minute speech. i'm going to cut you off. let's go right to the question. let's move things along here tonight because we have a lot of people and questions. last night we probably had at least if not more. we had probably 250, at least 250 people there. a night before in iron wood we probably had a good 150. so interest is great on what's going on in this country. to give you a quick example, you take a look at 2008 was the election year. we saw a big spike in mail, emails, fax, messages. we had to answer about 50,000. we answered 50,000 letters, inquiries into our office. as of december of this year, 50,000 last year, and that was about 20% increase from the

previous year, as of december we're at about 82,000. and i'm sure by the time we close the books on 2009 we're probably pushing close to 90,000 inquiries. now, we have the same staff. we're trying to answer them. some answers might be a little slow with that volume. that's almost a 50% increase in the last year alone. and i think the reason is because we're doing a number of things. before i go much farther, the president of michigan tech, i want to thank michigan tech for trying to aaccumulate date us and the video -- accommodate us and the video setup. thanks, michigan tech. but when president obama came in in jans, we've been handed a lot of issues. a lot of issues congress has said we'll address later, we'll kick the can down the road. we can't deal with that right now. whether you agree with the president or not or this democratically controlled congress or not, we've been

tackling the issues. and that has caused concerns. and we have a -- when we came into office, when president obama came into office, the economy was in a free fall. we're fighting two wars that we haven't paid for. we have health care issues. we've got chrysler, g.m., they were in trouble. so in this first year alone, one of the first bills is equal pay for equal work. let women or not let, women should be paid the same as men. ok. it was a lilly ledbetter case where women on average make about 87 cents to doing the same job a man does. 87 cents on the dollar. we finally made it law you should pay women the same as you pay a man. equal pay for equal work. that's signed into law. february we signed the expansion of the schip, the state children's health insurance program. 10 million more young people are on that health care program. we did an economic stimulus

package. american recovery reinvestment act. we did the loan, g.m. and chrysler. you name it, this congress has tackled it. i'm not saying everything we've done is perfect. a lot of what we've done has gone to the senate and we're still waiting for the senate to act. and, of course, one of the biggest bills we've ever done is health care. as you know i sit on the energy and commerce committee that has jurisdiction over health care. we'll get into that a little bit more. one other bill we did besides the economic recovery package to try to get this economy going, stop the freefall, get people back to work, try to look forward, move forward with our economy. just before we left in mid december we passed another bill called main street jobs bill. that bill came about as the states were telling us -- as you know, every five years we do a highway bill. we take money out of the

highway trust fund and use it to do roads, bridges, transportation projects. it's a five-year program. that program expired in october. the states said, well, we like the program because 80% is paid from the highway trust fund money, we have to put up a 20% match. but they said our economy, not just michigan, the economy throughout the nation is so poor we cannot come up with the matching funds anymore. like michigan left around 600 million, i think it was on, on the table. they couldn't use the money because they didn't have the 20% match. so what we did before we left in december around the 16th, 17, 18th of december, we passed this main street jobs bill. what we said is instead of doing a five-year highway bill, why don't we take what we normally spend which is $127 billion on infrastructure, highways and bridges, move it out of the trust fund and instead of having the matching funds or matching share 20% that states don't have it will be 100% paid for by the federal

government? now, for every $1 billion you spend, they estimate it creates or preserves 27 -- excuse me, 23,000 jobs. so that was our thought process. that bill has passed. there's a couple other things in that bill. there's revolving loan funds for water, infrastructure projects. that's in the bill. it's about $47 million. $27.5 billion. there's another extension of unemployment in that legislation. the 14-week extension. and there's a couple other things in there. that bill passed. it went to the senate. i expect the senate -- they're back next week also -- to take that bill up soon. the president said he'd like that bill passed by the end of january. doesn't do us any good to wait until march, april, may to pass the bill and then say, ok, now do your road projects. as we know by october, november, we have snow up here and we lose another construction season. this bill, this jobs bill, where we have 100% federal